Ganesa Wegienka

Henry Ford Hospital, Detroit, Michigan, United States

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Publications (150)803.19 Total impact

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    ABSTRACT: Objectives: African American children are at higher risk of obesity than White children and African American women are more likely to undergo caesarean-section (CS) delivery than White women. CS is associated with childhood obesity, however, little is known whether this relationship varies by race.We examined if the association of CS with obesity at age 2 years varied by race. Design: Longitudinal birth cohort.Setting: Birth cohort conducted in a health care system in metropolitan Detroit, Michigan with follow-up at age 2 years.Participants: 639 birth cohort participants; 367 children (57.4%) were born to African American mothers and 230 (36.0%) children were born via CS.Main Outcome Measure: Obesity defined as body mass index ≥95th percentile at age 2 years.Results: Slightly more children of African American (n=37; 10.1%) than non-African American mothers (n=18; 6.6%) were obese (P=.12). There was evidence of effect modification between race and delivery mode with obesity at age 2 years (interaction P=.020). In children of African-American mothers, CS compared to vaginal birth was associated with a significantly higher odds of obesity (aOR=2.35 (95% CI: 1.16, 4.77), P=.017). In contrast, delivery mode was not associated with obesity at age 2 years in children of non-African-American mothers (aOR=.47 (95% CI: .13, 1.71), P=.25). Conclusions: There is evidence for a race-specific effect of CS on obesity at age 2 years; potential underlying mechanisms may be racial differences in the developing gut microbiome or in epigenetic programming. Future research is needed to determine if this racial difference persists into later childhood. Ethn Dis. 2016;26(1):61-68; doi:10.18865/ed.26.1.61
    No preview · Article · Jan 2016 · Ethnicity & disease
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    ABSTRACT: Rates of childhood obesity have risen at the same time rates of high blood lead levels (BLLs) have fallen. Recent studies suggest that higher BLL is inversely associated with body size in older children (ages 3-19 years). No contemporaneous studies have examined if having a detectable BLL is associated with body size in very early childhood. We examined if detectable BLL is associated with body size in early childhood. A total of 299 birth cohort participants completed a study visit at ages 2-3 years with weight and height measurements; prior to this clinic visit, a BLL was drawn as part of routine clinical care. Body mass index (BMI) percentile and Z-score were calculated; children with BMI ≥85th percentile were considered overweight/obese at age of 2 years. Detectable BLL was defined as BLL ≥1 μg/dL. A total of 131 (43.8 %) children had a detectable BLL measured at mean aged 15.4 ± 5.5 months. Mean age at body size assessment was 2.2 ± 0.3 years (53.2 % male, 68.6 % African-American). After adjusting for race, sex, and birth weight, children with a detectable BLL had a 43 % lower risk of BMI ≥85th percentile (P = 0.041) and a 0.35-unit lower BMI Z-score (P = 0.008) compared to children without a detectable BLL. Neither race nor sex modified this association (all interactions P > 0.21). Consistent with recent studies in older children, having a detectable BLL was associated with smaller body size at ages 2-3 years. Additional research on the mechanism of this association is needed but may include mechanisms of appetite suppression via lead.
    Full-text · Article · Sep 2015 · Biological trace element research
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    ABSTRACT: Uterine fibroids are common, benign, smooth-muscle tumors that can cause major morbidity for reproductive-age women, often requiring invasive treatment. Despite this personal and public health burden, no prior study has attempted to periodically screen fibroid-free women with ultrasound to detect incident disease and identify risk factors. We designed a study to prospectively investigate development of fibroids by enrolling women without a clinical diagnosis of fibroids and screening for fibroids with ultrasound at baseline. Enrollment procedures included extensive questionnaires and specimen collection (blood, urine, vaginal swabs). The cohort is followed at approximately 20-month intervals. At each follow-up there are updates to the questionnaire data, further specimen collection, and an ultrasound examination. We identify incident disease and measure tumor growth. The two exposures of primary interest are vitamin D insufficiency and reproductive tract infections. This manuscript provides a detailed description of the study methods, recruitment results, and participant characteristics. The Study of Environment, Lifestyle and Fibroids enrolled 1,696 African American women aged 23-34 years. "Family and friends" was a leading recruitment source. More than 95% of participants contributed all the requested biological specimens at baseline. Study ultrasound examinations revealed undiagnosed fibroids in 378 women (22% of participants). The retention rate for the first follow-up was 87%. Study design aspects likely to be important for long-term studies in young African Americans include personalized recruitment, multiple steps to the enrollment process that rely on the initiative of the participant, and methods for tracing highly mobile study subjects.
    No preview · Article · Sep 2015 · Journal of Women's Health
  • R. Sangha · K. Jones · S. Havstad · G. Wegienka
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    ABSTRACT: OBJECTIVE: To assess whether body mass index (BMI) was associated with self-reported pain, well-being, or procedure satisfaction in the 3 months after hysterectomy.
    No preview · Article · Sep 2015
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    ABSTRACT: Early patterns of gut colonization may predispose children to adult disease. Exposures in utero and during delivery are associated with the infant gut microbiome. Although ~35% of women carry group B strep (GBS; Streptococcus agalactiae) during pregnancy, it is unknown if GBS presence influences the infant gut microbiome. As part of a population-based, general risk birth cohort, stool specimens were collected from infant's diapers at research visits conducted at ~1 and 6 months of age. Using the Illumina MiSeq (San Diego, CA) platform, the V4 region of the bacterial 16S rRNA gene was sequenced. Infant gut bacterial community compositional differences by maternal GBS status were evaluated using permutational multivariate analysis of variance. Individual operational taxonomic units (OTUs) were tested using a zero-inflated negative binomial model. Data on maternal GBS and infant gut microbiota from either 1 (n=112) or 6-month-old stool (n=150) specimens was available on 262 maternal-child pairs. Eighty women (30.5%) were GBS+, of who 58 (72.5%) were given intrapartum antibiotics. After adjusting for maternal race, prenatal antifungal use and intrapartum antibiotics, maternal GBS status was statistically significantly associated with gut bacterial composition in the 6 month visit specimen (Canberra R 2=0.008, P=0.008; Unweighted UniFrac R 2=0.010, P=0.011). Individual OTU tests revealed that infants of GBS+ mothers were significantly enriched for specific members of the Clostridiaceae, Ruminococcoceae, and Enterococcaceae in the 6 month specimens compared with infants of GBS- mothers. Whether these taxonomic differences in infant gut microbiota at 6 months lead to differential predisposition for adult disease requires additional study.
    No preview · Article · Aug 2015
  • Tarek Toubia · Lauren Schiff · Ganesa Wegienka · Roopina Sangha
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    ABSTRACT: Background: Robotic-assisted hysterectomy (RH) has the same clinical benefits as laparoscopy and offers surgeons additional benefits. However, RH-related costs are high and its clinical benefits have not been shown to be better than those achieved with laparoscopy. A key cost factor is the length of (hospital) stay (LOS). Objective: The aim of this study was to identify the relationship between uterine weight and LOS following RH and potential risk factors for extended LOS. Materials and Methods: This study involved a retrospective cohort of all RHs performed in a midwestern tertiary-care teaching hospital and its suburban affiliates, from January 2011 to December 2012. Data were collected using Current Procedural Terminology codes. The current authors examined if any of several variables were associated with uterine weight, using Spearman's correlation for continuous variables and Wilcoxon's rank sum or Kruskal-Wallis test for categorical variables. Comparison of variables between patients who did and who did not have a LOS>1 day was performed using a Wilcoxon rank sum test for continuous variables and a Chi-square or Fisher's exact test for categorical variables. Those that were associated with both uterine weight and LOS were considered as potential confounders and were included in the logistic regression model. The adjusted odds ratio (OR) for a 100-g increase in uterine weight was calculated. Results: Of 239 patients who underwent RH, 48 (20%) had a LOS>1 day. Uterine weight was significantly greater among patients with LOS>1 day (483 g versus 337 g; p=0.008). Patients who had LOS>1 day had a greater estimated blood loss (EBL; means: 178 mL versus 95 mL; p=0.006) and a significantly longer procedure duration (means: 236 minutes versus 168 minutes; p<0.005), compared to patients with LOS=1. In addition, patients with LOS>1 day had higher baseline pain scores (4.5 versus 3.2; p=0.003). Number of ports and oophorectomy were both significantly associated with LOS. For a 100-g increase in uterine weight, there was 1.12 times the odds of having LOS>1 day (OR=1.12; 95% confidence interval: 1.02, 1.21). After controlling for procedure duration, EBL, number of ports, transfusion rates and oophorectomy, the adjusted OR (aOR) was not significant (aOR=1.0; CI: 0.89, 1.12). Conclusions: When adjusted for procedure duration, EBL, number of ports, transfusion rates, and oophorectomy, uterine weight was not associated with LOS after RH. Larger studies are needed to explore further the associations among procedure duration, EBL, baseline pain scores, oophorectomy, and number of ports used with prolonged LOS after RH. Pain management seemed to be the single greatest indication for increased LOS after RH. (J GYNECOL SURG 00:1)
    No preview · Article · Jul 2015 · Journal of Gynecologic Surgery
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    ABSTRACT: Background: Allergy-related studies that include biological measurements of vitamin D preceding well-measured outcomes are needed. Objective: We sought to examine the associations between early-life vitamin D levels and the development of allergy-related outcomes in the racially diverse Wayne County Health, Environment, Allergy, and Asthma Longitudinal Study birth cohort. Methods: 25-Hydroxyvitamin D (25[OH]D) levels were measured in stored blood samples from pregnancy, cord blood, and age 2 years. Logistic regression models were used to calculate odds ratios (ORs) with 95% CIs for a 5 ng/mL increase in 25(OH)D levels for the following outcomes at age 2 years: eczema, skin prick tests (SPTs), increased allergen-specific IgE level (≥0.35 IU/mL), and doctor's diagnosis of asthma (3-6 years). Results: Prenatal 25(OH)D levels were inversely associated with eczema (OR, 0.85; 95% CI, 0.75-0.96). The association was stronger in white children (white children: OR, 0.79; 95% CI, 0.57-1.09; black children: OR, 0.96; 95% CI, 0.82-1.12), although this was not statistically significant. Cord blood 25(OH)D levels were inversely associated with having 1 or more positive SPT responses and aeroallergen sensitization. Both associations were statistically significant in white children (positive SPT response: OR, 0.50; 95% CI, 0.32-0.80; ≥1 aeroallergen sensitization: OR, 0.50; 95% CI, 0.28-0.92) in contrast with black children (positive SPT response: OR, 0.88; 95% CI, 0.68-1.14; ≥1 aeroallergen sensitization: OR, 0.85; 95% CI, 0.65-1.11). 25(OH)D levels measured concurrently with outcome assessment were inversely associated with aeroallergen sensitization (OR, 0.79; 95% CI, 0.66-0.96) only among black children (white children: OR, 1.21; 95% CI, 0.87-1.69). Conclusions: Prenatal and cord blood 25(OH)D levels were associated with some allergy-related outcomes, with a general pattern indicating that children with higher 25(OH)D levels tend to have fewer allergy-related outcomes.
    No preview · Article · Jun 2015 · The Journal of allergy and clinical immunology
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    ABSTRACT: Objective: To observe the occurrence of pregnancy in women undergoing minimally invasive and open myomectomy for symptoms attributed to uterine fibroids and who desire future pregnancy. Methods: We performed a retrospective chart review of women who had undergone myomectomy at least two years previously within the Henry Ford Health System in Detroit, MI. We reviewed the subsequent fertility outcomes according to the fertility goals identified by each woman. Results: During the seven-year observation window, 310 women underwent myomectomy and 124 (40%) of these women desired pregnancy. Forty-nine women desiring pregnancy (40%) conceived, and 30 (61% of those who conceived) delivered a viable infant from their first pregnancy. In addition, two women had a live birth after a miscarriage, and one had a live birth after an ectopic pregnancy. Five women had a second live-born baby. There were no differences in the occurrence of pregnancy or pregnancy outcome according to surgical approach, patient age or race, number of uterine incisions, or whether the endometrial cavity was entered. In addition, five of 186 women who did not have a fertility goal (3%) conceived, and one woman delivered two babies. Conclusion: Myomectomy performed to preserve fertility resulted in approximately one in four women having a live birth, independent of surgical technique.
    No preview · Article · Mar 2015 · Journal of obstetrics and gynaecology Canada: JOGC = Journal d'obstetrique et gynecologie du Canada: JOGC

  • No preview · Article · Feb 2015 · Journal of Allergy and Clinical Immunology

  • No preview · Article · Feb 2015 · Journal of Allergy and Clinical Immunology

  • No preview · Article · Feb 2015 · Journal of Allergy and Clinical Immunology

  • No preview · Article · Feb 2015 · Journal of Allergy and Clinical Immunology

  • No preview · Article · Feb 2015 · Journal of Allergy and Clinical Immunology
  • Ganesa Wegienka · Edward Zoratti · Christine Cole Johnson
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    ABSTRACT: A consensus has been reached that the development of allergic disorders is strongly influenced by early life exposures. An overview of several prenatal and early life factors that have been investigated for their associations with development of childhood allergy is presented. Delivery mode, the gut microbiome, vitamin D, folate, breastfeeding, pets, antibiotics, environmental tobacco smoke, and airborne traffic pollutants are discussed. Although many studies suggest an effect, overall, no risk factors clearly increase or reduce the risk of allergic outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.
    No preview · Article · Feb 2015 · Immunology and Allergy Clinics of North America

  • No preview · Article · Feb 2015 · Journal of Allergy and Clinical Immunology
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    ABSTRACT: Background Separately, prenatal antibiotics and Caesarian delivery have been found to be associated with increased risk of allergic diseases. It is not clear whether these factors may modify the effect of each other.Objective To assess whether the associations between delivery types and eczema, sensitization and total IgE at age 2 years were modified by maternal use of prenatal medications.Methods Prenatal charts of women enrolled in the WHEALS birth cohort were reviewed for delivery mode and medications prescribed and administered throughout their entire pregnancy, including systemic antibiotics and vaginally applied antifungal medications. The associations between the delivery mode and select medications and, eczema, sensitization (≥ 1 of 10 allergen-specific IgE ≥ 0.35 IU/mL) and total IgE at age 2 years were assessed.ResultsThere was a lower risk of eczema among vaginally vs. c-section born children (relative risk adjusted for race = aRR = 0.77, 95% CI 0.56, 1.05). Although not statistically significantly different, this association was stronger among the subset of children born vaginally to a mother who did not use systemic antibiotics or vaginal antifungal medications (aRR = 0.69, 95% CI 0.44, 1.08) compared to those born vaginally to mothers who used systemic antibiotics or vaginal antifungals (aRR = 0.81, 95% CI 0.57, 1.14). A protective association between vaginal birth and sensitization (aRR = 0.86, 95% CI 0.72, 1.03) was similar for those children born vaginally to a mother who did not (aRR = 0.87, 95% CI 0.69, 1.10) and who did (RR = 0.85, 95% CI 0.70, 1.04) use systemic antibiotics or vaginal antifungal medications. There were no associations with total IgE.Conclusions Children born vaginally had lower risk of eczema and sensitization compared with those born via c-section; however, the protective association with eczema may be slightly weakened when mothers took systemic antibiotics or vaginally applied medications during pregnancy.
    No preview · Article · Dec 2014 · Clinical & Experimental Allergy
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    ABSTRACT: There is consistent evidence demonstrating that pet-keeping, particularly of dogs, is beneficial to human health. We explored relationships between maternal race and prenatal dog-keeping, accounting for measures of socioeconomic status that could affect the choice of owning a pet, in a demographically diverse, unselected birth cohort. Self-reported data on mothers' race, socioeconomic characteristics and dog-keeping practices were obtained during prenatal interviews and analyzed cross-sectionally. Robust methods of covariate balancing via propensity score analysis were utilized to examine if race (Black vs White), independent of other participant traits, influenced prenatal dog-keeping. A birth cohort study conducted in a health care system in metropolitan Detroit, Michigan between September 2003 and November 2007. 1065 pregnant women (n=775 or 72.8% Black), between ages 21 and 45, receiving prenatal care. Participant's self-report of race/ethnicity and prenatal dog-keeping, which was defined as her owning or caring for > or =1 dog for more than 1 week at her home since learning of her pregnancy, regardless of whether the dog was kept inside or outside of her home. In total, 294 women (27.6%) reported prenatal dog-keeping. Prenatal dog-keeping was significantly lower among Black women as compared to White women (20.9% vs 45.5%, P<.001), and remained significantly different even after propensity score analysis was applied. Findings suggest that there are persistent racial differences in dog-keeping not fully explained by measures of socioeconomic status. Racial differences in prenatal dog-keeping may contribute to childhood health disparities.
    No preview · Article · Dec 2014 · Ethnicity & disease
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    ABSTRACT: Caesarean-section (CS) delivery increases risk of childhood obesity, and is associated with a distinct early-life gut microbiome, which may contribute to obesity. Household pets may alter human gut microbiome composition. We examined if pet-keeping modified the association of CS with obesity at age 2 years in 639 Wayne County Health, Environment, Allergy and Asthma Longitudinal Study birth cohort participants. Pet-keeping was defined as having a dog or cat (indoors ≥1 h/day) at child age 2 years. We used logistic regression to test for an interaction between CS and pet-keeping with obesity (BMI ≥ 95th percentile) at age 2 years, adjusted for maternal obesity. A total of 328 (51.3 %) children were male; 367 (57.4 %) were African American; 228 (35.7 %) were born by CS; and 55 (8.6 %) were obese. After adjusting for maternal obesity, CS-born children had a non-significant (P = 0.25) but elevated 1.4 (95 % CI 0.8, 2.5) higher odds of obesity compared to those born vaginally. There was evidence of effect modification between current pet-keeping and delivery mode with obesity at age 2 years (interaction P = 0.054). Compared to children born vaginally without a pet currently in the home, children born via CS without a pet currently in the home had a statistically significant (P = 0.043) higher odds (odds ratio 2.00; 95 % CI 1.02, 3.93) of being obese at age 2 years. Pets modified the CS-BMI relationship; whether the underlying mechanism is through effects on environmental or gut microbiome requires specific investigation.
    No preview · Article · Nov 2014 · Maternal and Child Health Journal

  • No preview · Article · Nov 2014 · Journal of Allergy and Clinical Immunology
  • R. Sangha · S. Havstad · G. Wegienka

    No preview · Article · Nov 2014 · Journal of Minimally Invasive Gynecology

Publication Stats

969 Citations
803.19 Total Impact Points

Institutions

  • 2008-2015
    • Henry Ford Hospital
      • Department of Internal Medicine
      Detroit, Michigan, United States
  • 2003-2015
    • Henry Ford Health System
      • Department of Public Health Sciences
      Detroit, Michigan, United States
    • National Institutes of Health
      • Branch of Epidemiology (EPI)
      Maryland, United States
    • University of North Carolina at Chapel Hill
      • Department of Epidemiology
      North Carolina, United States
  • 2011
    • Johns Hopkins University
      Baltimore, Maryland, United States
  • 2006
    • University of Wisconsin–Madison
      Madison, Wisconsin, United States
    • University of Chicago
      • Department of Molecular Genetics & Cell Biology
      Chicago, Illinois, United States
  • 2004
    • University of California, Davis
      • Area of Epidemiology and Preventive Medicine
      Davis, California, United States